Bundled payments gain momentum among insurers, providers


Surveys of insurers, patients, providers and employers show bundled payments have generated increasing momentum across the healthcare industry as a way to reduce costs and boost transparency.

"There is mounting evidence that bundles will be a critical part of any solution for the U.S. healthcare system--a means to deliver a higher-quality patient experience, achieve better results and reduce costs," Gary Ahlquist, senior partner with Booz & Company, wrote in the company's Strategy + Business magazine. 

But insurers, which Ahlquist calls the "most crucial link" to the success of bundled payments because they connect hundreds of millions of patients with providers and employers, are somewhat skeptical of bundling. Some insurers question the longevity of bundled payments.

"By improving outcomes and reducing costs, bundled care represents a rare win-win for the demand side (patients and employers) and the supply side (payors and providers)," he said.

In a survey of employers and insurers, Booz & Company found 31 percent of the 58 participating insurers already are pursuing bundled payments, while 47 percent are interested in bundling.

For example, Blue Cross Blue Shield of North Carolina has launched a successful bundled payment program for knee replacement surgeries, partnering with two prominent health systems to bill members one total amount for each service related to their knee replacement, FierceHealthPayer previously reported.

And even the federal government has gotten involved in the bundled payment action. The Centers for Medicare & Medicaid Services launched a new initiative to bundle payments for 500 Medicare providers early this year. The Bundled Payments for Care Improvement program, created under the reform law, lets CMS test four models of payments based on episodes of care rather than single line items, FierceHealthcare previously reported.

To learn more:
- read the Strategy + Business article
- here's the Booz & Company survey

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